基于肿瘤免疫微环境的胃癌中医药防治

Prevention and Treatment of Gastric Cancer by Chinese Medicine Based on Tumor Immune Microenvironment

随着"带瘤生存"理念的提出,肿瘤免疫微环境在肿瘤生长、发展及转移中的作用备受关注,调控肿瘤免疫微环境为胃癌的防控提供了新方向。中医药在防控胃癌的生长、进展及转归,或术后及放化疗后的并发症及不良反应等方面有独特优势,与调控胃癌免疫微环境密切相关,主要表现为增强免疫监视、克制免疫抑制、调控免疫逃逸,以改善胃癌免疫微环境,防控胃癌于早期。然而现有研究仍存在一些不足之处:①肿瘤免疫微环境的形成和动态变化是多方面、多靶点的,涉及多种免疫细胞及细胞因子,其在胃癌发生、发展及转归中的具体作用机制有待进一步探究;②中医药治疗方法众多,作用机制和靶点多样,中医药如何通过调控肿瘤免疫微环境防控肿瘤尚需更深入的研究;③目前对于胃癌肿瘤免疫微环境的研究以临床观察类居多,对胃癌分类分型及相关分子机制的研究较少,且临床观察样本量较小,对于全面揭示中医药的调控机制尚有较大提升空间。未来需进一步拓宽肿瘤免疫微环境的内涵,持续完善肿瘤免疫微环境的中医本质,不断探究肿瘤免疫微环境在胃癌进程中发挥的作用,全面分析中医药调控胃癌免疫肿瘤微环境的具体机制,让胃癌的中医药免疫防治更加标准化、规范化。

With the concept of " survival with tumors" put forward,the role of tumor immune microenvironment in the growth,development and metastasis of tumors has attracted much attention. Regulation of tumor immune microenvironment provides a new direction for the prevention and control of gastric cancer. Chinese medicine has unique advantages in preventing and controlling the growth,progress and prognosis of gastric cancer,or the complications and toxic side effects after operation and radiotherapy and chemotherapy. It is closely related to regulating the immune microenvironment of gastric cancer. The main manifestations are enhancing immune surveillance,restraining immune suppression and regulating immune escape,so as to improve the immune microenvironment of gastric cancer and prevent and control the early stage of gastric cancer. However,there are still some deficiencies in the current research:(1) the formation and dynamic changes of tumor immune microenvironment are multi-faceted and multi-target,involving a variety of immune cells and cytokines,and its specific mechanism in the occurrence,development and prognosis of gastric cancer needs to be further explored;(2)there are many methods of TCM treatment,and there are many mechanisms and targets,and how TCM can prevent and control tumors by regulating the immune microenvironment of tumors still needs more in-depth study;(3)at present,most of the studies on the immune microenvironment of gastric cancer are based on clinical observation. There are few studies on the classification and classification of gastric cancer and related molecular mechanisms,and the number of clinical observation samples is small. There is still much room to fully reveal the regulatory mechanism of traditional Chinese medicine. In the future,we need to further broaden the connotation of tumor immune microenvironment,continuously improve the essence of traditional Chinese medicine,constantly explore the role of tumor immune microenvironment in the process of gastric cancer,and comprehensively analyze the specific mechanism of Chinese medicine regulating the immune microenvironment of gastric cancer,so as to make the traditional Chinese medicine immune prevention and treatment of gastric cancer more standardized and standardized.